Craniofacial fibrous dysplasia: a challenge for general dental practitioners

Craniofacial fibrous dysplasia (CFD) is an asymptomatic disease that can have oral manifestations with severe effects on a patient's wellbeing. It is usually diagnosed based on patient concerns, including poor appearance due to spacing and functional difficulties in eating and speaking, as well as the presenting features, such as facial asymmetry and corresponding malocclusion, delayed or abnormal tooth eruption, and painless swelling or bony expansion. General dental practitioners (GDPs) will often see patients presenting with these multiple symptoms which can be overwhelming. An awareness of the oral and dental features is thus important to make an early diagnosis and to ensure that the patient is given the best advice and guidance early on what is available to address their concerns. This paper provides an overview of the oral and dental features associated with CFD and presents two cases in whom delayed diagnosis resulted in complex treatment needs to address their concerns. Both cases highlight the importance of early diagnosis and the essential role of GDPs in early recognition of the condition to optimise patient care and wellbeing.